Cardiac Arrest
A final serious abnormality of the cardiac rhythmicity-conduction
system is cardiac arrest. This
results from cessation of all electrical control signals in the heart. That is,
no spontaneous rhythm remains.
Cardiac arrest is especially likely to occur during deepanesthesia, when many patients develop severe
hypoxiabecause of inadequate respiration. The hypoxia pre-vents the muscle
fibers and conductive fibers from main-taining normal electrolyte concentration
differentials across their membranes, and their excitability may be so affected
that the automatic rhythmicity disappears.
In most instances of
cardiac arrest from anesthesia, prolonged cardiopulmonary resuscitation (many
minutes or even hours) is quite successful in re-establishing a normal heart
rhythm. In some patients, severe myocardial disease can cause permanent or
semipermanent cardiac arrest, which can cause death. To treat the condition,
rhythmical electrical impulses from an implanted
electronic cardiac pacemaker have been used successfully to keep patients
alive for months to years.
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